A new report by Express Scripts Holding Co. finds that, while the total costs of U.S. drug payments rose slightly last year, 2012 was the first time in two decades that spending on drug treatments for common ailments such as high cholesterol and diabetes declined. That drop is largely due to Americans’ increasing use of generic — rather than brand name — medications to treat the conditions.

As Reuters reports, brand name companies have the freedom to charge higher rates on their prescription drugs for a set period of time before their patents lapse into the public domain, allowing expanded use of less costly generic drugs — a practice that is also encouraged by Obamacare:

The lower prices for common drugs came after the patents on branded versions ran out, putting cheaper generic competitors onto the market. Big pharmaceutical companies like Pfizer Inc and Merck & Co hold the patents on drugs for about a decade after they start selling them. Then competitors like Teva Pharmaceuticals Ltd can start selling their own generic versions.

President Barack Obama’s healthcare overhaul law rewards the use of generic drugs as a way to decrease healthcare spending, which rose about 4 percent last year and accounts for about 17 percent of gross domestic product.

The patent for Pfizer’s Lipitor, a cholesterol treatment that was once the world’s best-selling drug, expired in November 2011. Cheaper generics hit the market soon after, which sharply reduced spending on treatments in 2012.

“The move towards lower-cost generic alternatives has had a tremendous impact,” said Sharon Frazee, vice president research and analytics at Express Scripts.

Falling drug prices can have a tangible impact on Americans’ treatments for obesity-related illnesses that take a particularly large toll on the nation’s health. For example, the cost of high cholesterol medication fell by 10 percent for a 30-day supply — which quickly adds up for Americans who have chronic conditions like excess cholesterol and diabetes.

But Americans are denied the full benefits of falling generic drug prices due to the abundance of so-called “pay-for-delay” schemes between brand name and generic drug companies — when brand name drug companies pay off generic drug manufacturers in exchange for their consent to delay the release of a drug’s generic version into the market, a method of maximizing the brand name drug’s profitability. The Supreme Court is set to take up a case — Federal Trade Commission v. Watson Pharmaceuticals — to determine whether or not such schemes violate consumer protections and antitrust laws.

And the outcome of that decision could have a significant impact on U.S. health care expenditures. Considering the fact that the new report found the overall increase in national drug spending was driven by the high costs of specialty drugs for arthritis, cancer, and hepatitis C, which “accounted for 24.5 percent of the nation’s total spending on prescription drugs,” encouraging the production of generic prescription drugs could go a long way towards lowering health care costs.

Continuing the Republican propensity to use every single policy and political issue imaginable as an excuse to launch attacks against Obamacare, Rep. Charles Boustany (R-LA) — a member of the powerful House Ways and Means Committee — asserted on Tuesday that Congressional efforts to comprehensively overhaul America’s tax code would include measures to repeal several important Obamacare funding provisions.

Boustany explained that the Obamacare tax measures “will be considered, most likely, in the context of fundamental tax reform,” since wrapping them into a bipartisan tax reform bill makes them more difficult to vote against. Among the provisions on the chopping block would be Obamacare’s 2.3 percent tax on medical devices, as well as a tax on so-called “Cadillac” health plans that wealthier Americans may choose to purchase.

The GOP-led House already voted to repeal the medical device tax, and as many as 17 Democratic senators have voiced their support for getting rid of the tax. But revenue sources such as the medical device tax and the fee on high-end health plans are crucial to funding Obamacare’s subsidies for buying private insurance, its expansion of the public Medicaid program, and its consumer protections for Americans pursuing health coverage.

While there has been some debate over the wisdom of the medical device tax — particularly since some lawmakers worry it could place too much burden on hospitals and device manufacturers — it will help provide tens of billions of dollars in Obamacare funding, along with the law’s other tax measures. Replacing that funding won’t come out of thin air. The lawmakers pushing for repeal will need to make sure that alternative revenue is available to carry out important provisions of the health reform law that seek to extend coverage to millions of Americans.

Boustany’s comments make one thing crystal clear: Obamacare opponents will continue using every possible piece of legislation as a vehicle for obstructing health reform. And, given national lawmakers’ mercurial approach to budgeting, there’s always the distinct possibility that Congress will be tempted to take away more and more funding once they begin chipping away at some of Obamacare’s revenue sources.

In order to avert a government shutdown later this month, Congress and the Obama administration must negotiate a continuing resolution to maintain federal funding — and a group of House Republicans is suggesting that deal should also roll back Obamacare’s effort to expand women’s access to affordable contraception.

The automatic spending cuts that will take effect under sequestration will already compromise programs that disproportionately impact women, including slashing $86 million from critical family planning and reproductive health services. But that’s not enough for Republican lawmakers, who want to use the upcoming budget negotiations as yet another opportunity to keep attacking women’s health:

GOP lawmakers reintroduced a bill Tuesday to repeal the contraception mandate. They also pressed their party’s leaders to roll back the provision as part of a continuing resolution later this month to keep the federal government operating.

“This attack on religious freedom demands immediate congressional action,” the 14 lawmakers wrote. “Nothing short of a full exemption for both nonprofit and for-profit entities will satisfy the demands of the Constitution and common sense.”

The continuing resolution that House appropriators released Monday would not cut off funding for the Affordable Care Act, despite years of conservative pressure to defund the healthcare law. But Tuesday’s letter, led by Rep. Diane Black (R-Tenn.), indicates that fights over the health law could still roil the funding debate.

Obamacare’s birth control provision, which went into effect on August 1, helped eliminate the gender-based disparity in health costs by eliminating co-pays for women’s contraceptive services. Studies have proven that increasing access to cost-free birth control lowers the rates of unintended pregnancy and abortion, as well as provides women with greater economic autonomy to achieve their personal financial goals. Nevertheless, right-wing Obamacare opponents misconstrue the law as a threat to religious freedom, despite the fact that it already contains an exemption for faith-based organizations that oppose covering contraception.

Despite Republicans’ insistence that Obamacare is an affront to religious liberty, most Americans don’t agree. A diverse coalition in support of the health reform law’s expanded access to contraception — including religious groups like Catholics for Choice, Jewish Women International, the Religious Coalition for Reproductive Choice, the United Methodist Church, and the Unitarian Universalist Association — is already urging the U.S. House Committee on Appropriations to reject a deal that would restrict women’s access to birth control.

Unfortunately, Rep. Black is no stranger to targeting women’s health. So far this session, she has also introduced a measure to defund Planned Parenthood, as well as called for an unnecessary government study to justify her continued effort to strip funding from the women’s health organization.

Former Florida Gov. Jeb Bush (R) appeared on MSNBC’s The Daily Rundown on Tuesday morning to discuss, among other things, a potential presidential run in 2016. And his future political aspirations are already forcing him to choose his words carefully. Even though Bush is an ardent opponent of Obamacare’s Medicaid expansion in private, he wouldn’t go on the record to oppose Gov. Rick Scott’s (R-FL) recent decision to extend health coverage to an estimated 1.3 million low-income Floridians.

Obamacare’s state-level Medicaid expansion is popular with the public, and an increasing number of GOP leaders — including Florida’s — are finally awakening to the reality that accepting federal funds to expand Medicaid is the right move for their constituents as well as for their state budgets. That shift is forcing anti-Obamacare politicians like Bush to mask their opposition to expansion. When host Chuck Todd asked Bush whether he agreed with Scott’s new position on Medicaid expansion, the former governor claimed he’s been too “busy” to form an opinion on the subject:

TODD: Did you think it was the right decision? Would you have made that call?

BUSH: Anytime you have a chance to advocate reform, you should. So Medicaid needs to be reformed. If you’re going to expand it by 50 percent, it sure better be a dramatically different system. And in Florida, there’s a waiver that has been approved that could be that reform — that expands on the reforms that I had a chance to advocate when I was governor. So if the focus is on making Medicaid work for people and that it won’t create this out year costs that people anticipate, that somehow the reform will yield a better result, then okay. Then give him credit. But I haven’t heard that yet –

TODD: You’re not there yet.

BUSH: I guess I’ve been busy, I haven’t been watching the specifics of it. If that’s the case, kudos to the governor. If it isn’t, then he’s put the state in a precarious position three or four years out.

It’s likely not a politically smart move for Florida’s former governor to publicly come out in opposition to extending health coverage to low-income residents in his state, which has one of the highest uninsurance rates in the nation. As of two weeks ago, however, Bush had made up his mind enough to privately pressure Florida lawmakers to oppose expanding Medicaid — urging them to stand in direct opposition to Rick Scott and come up with an alternative to expansion. Those efforts may have paid off. The state’s GOP-controlled House of Representatives voted to reject Medicaid expansion on Monday, effectively stalling reform.

Bush demurred on his personal position on Scott’s decision, but he did indicate his support for Florida’s Medicaid waiver — which is essentially a proposal to shift the program’s beneficiaries toward private managed care. If Bush does begin paying more attention to the specifics of health policy, he may be interested to learn that Florida’s push to privatize the public program would likely be even more expensive than accepting Obamacare’s traditional expansion, since Medicaid is currently much cheaper than private insurance.

The GOP’s potential presidential candidates are split on the issue of Medicaid expansion. New Jersey Gov. Chris Christie agreed to expand Medicaid just last week — a position that may have landed him in hot water with the conservative establishment — but Louisiana Gov. Bobby Jindal remains opposed it, and Wisconsin Gov. Scott Walker has rejected Obamacare’s Medicaid expansion in favor of a risky proposal that may end up providing his state’s poor residents with a lower quality of coverage.

A months-long investigation by the American Independent has uncovered that the Michigan Department of Community Health has been secretly collecting detailed demographic information for the people who take HIV tests at community clinics — a practice that has been going on for more than a decade, despite the fact that it raises serious privacy concerns about the way the state is handling sensitive health care information.

When Michigan residents get tested for HIV at a federally-funded community clinic, their information — including age, birth date, and potential “risk categories” for contracting the virus — is entered into a massive state database that stores it indefinitely, regardless of the outcome of the test. The state-owned data could even include the identities of people who have sexual relationships with HIV-positive individuals. There’s no way for a Michigander to remove their information from the system once it has been entered.

The Department of Community Health says they simply want to track the number of tests conducted with federal grant money, and state officials claim that the database “does not contain personally identifiable information.” But outside investigations have found that there’s not enough security to safeguard the sensitive information, and anyone who works for the health department is able to access it. In fact, some of Michigan’s local health departments are using the database’s information to build criminal cases against HIV-positive individuals who they want to prosecute for failing to disclose their status — something that represents a potential breach of civil liberties:

“There are certainly privacy rights involved, particularly when clients are not being told that the information they are providing is being put in a database which can be utilized to assist with criminal prosecution of people living with HIV,” said Jay Kaplan, staff attorney for the American Civil Liberties Union of Michigan LGBT Project. “It’s ironic that in its effort to try to prevent transmission of HIV as part of the HIV-testing process, this policy and practice will likely discourage people from being tested, because they fear criminal prosecution for having knowledge of their HIV status.”

Rose Saxe, from the National ACLU AIDS Project, also weighed in on the issue. She said the state is collecting confidential health information, but also “deeply personal information.”

“The state has a constitutional obligation to keep this information secure, and to protect the privacy rights of people testing for HIV,” Saxe told TAI in an email. “Because of the sensitivity of this information, the ACLU believes it is critically important that the state have in place policies to ensure that this information is used appropriately. This includes safeguards to prevent inadvertent disclosure, and ways to ensure that it is only accessed for legitimate reasons by health department employees. If the state cannot or does not undertake steps to protect this deeply private information about people in Michigan, it has no business collecting and storing it indefinitely.”

Several studies have demonstrated that criminalizing HIV is not an effective policy to combat rates of infection. In fact, just as the ACLU’s Jay Kaplan points out, those type of punitive laws can actually dissuade people from learning their status because they’re worried about facing legal action. They also serve to reinforce the lingering stigma associated with the virus. Nevertheless, 34 states — including Michigan — have adopted criminal laws based on perceived exposure to HIV.

The Presidential Advisory Council on HIV/AIDS (PACHA) has called for the repeal of criminalization laws across the country. Even if Michigan doesn’t throw out its HIV-specific criminal laws, it could take immediate steps to stop secretly collecting data to enforce those laws without its residents’ knowledge.

With Obamacare on the pathway towards full implementation, critics have attempted to point out every perceived flaw in the health reform law to marshal public opinion against it. Recently, reform opponents have focused their sights on the rule that prevents insurers from charging seniors more than three times the premiums they charge younger Americans, claiming it will cause young people’s health premiums to skyrocket.

That provision is actually meant to protect seniors, who are costlier to cover, from excessive price gouging. But health reform critics point out that insurance companies may try to exploit the rule to raise prices for younger Americans, making these young people’s health coverage unaffordable. According to a new Urban Institute analysis, however, these allegations are rooted more in wishful thinking than policy reality.

According to the Urban Institute’s findings, the 3:1 premium ratio will have little effect on younger Americans, as “they will be eligible for either Medicaid or tax credits through state health insurance exchanges.” The study goes on to conclude that through a combination of elevated Medicaid/CHIP benefits, Obamacare’s provision allowing adults up to 26 years of age to stay on their parents’ insurance, and the health reform law’s private insurance subsidies for Americans living up to 400 percent of the federal poverty level (FPL), younger Americans will not experience the sort of “sticker shock” that the doomsayers have been foretelling:

Most young adults and families will be largely shielded from the full effects of the narrower age rating bands thanks to the ACA’s increased eligibility for Medicaid and tax credits offered through state health insurance exchanges or through access to employer-sponsored insurance. In fact, this is largely true across age groups. Eighty-five percent of policies sold through nongroup exchanges will be to those with incomes at or below 400 percent of federal poverty level (FPL), making them eligible for tax credits.

Looking specifically at young adults age 21–27 purchasing nongroup insurance today, two-thirds will be protected by Medicaid/CHIP or exchange-based subsidies under reform; two-thirds of the remainder are under age 26 and in homes where their parents have employer-based coverage for which they are eligible under the ACA’s dependent coverage provisions.

The study’s findings emphasize both the importance of states taking part in Obamacare’s optional Medicaid expansion and the tendency for Obamacare critics to portray the law as some sort of fiscal bogeyman. Even the media has been complicit in smearing the law, implicitly suggesting that some insurers’ plans to institute double-digit premium hikes are in anticipation of Obamacare’s expansive coverage requirements — they are not. The new Urban Institute analysis is yet further proof that there is a considerable gap between the rhetoric and the reality when it comes to Obamacare.

The scientific community is buzzing with the news that doctors may have cured a two-year-old girl of her HIV infection, marking the first time the virus has been eliminated from a child’s system. But thanks to sequestration, scientists may struggle to build upon that potentially groundbreaking study — since the automatic budget cuts that began going into effect at the beginning of the month will undermine this exact type of innovative medical research.

The National Institutes of Health (NIH), which co-funded the forthcoming study about the two-year-old’s case, is facing an 8.2 percent across-the-board cut as a result of sequestration. That will slash NIH’s $31 billion budget by about $1.6 billion — leaving considerably less funding for new biomedical research projects:

The NIH, in conjunction with the Foundation for AIDS Research, also known as amfAR, paid for the research of the child who was infected with HIV, the virus that causes AIDS.

Chris Collins, vice president of public policy for amfAR, said there was a “cruel irony” to the timing of the HIV cure discovery and sequestration.

“As we’ve heard this exciting news about cure research, the entire AIDS research field is experiencing a significant cutback,” said Collins. “If we were in the business of ending AIDS, this would be the time to invest, not pull our resources out.”

A former NIH director has already warned that the sequester cuts could set back medical science for a generation. Existing research will have to be scaled back, and significant cuts to grants could dissuade scientists from getting new projects off the ground.

And that’s not the only way that sequestration could potentially set back progress in combating the HIV/AIDS epidemic. Accpording to the Department of Health and Human Services, budget cuts will result in 424,000 fewer HIV tests conducted by state agencies, as well as an estimated 7,400 fewer patients able to access to their HIV medications through government assistance programs.